Provider Demographics
NPI:1952783953
Name:ELINA KHODZHAYEVA PODIATRY PC
Entity type:Organization
Organization Name:ELINA KHODZHAYEVA PODIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHODZHAYEVA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:347-622-2804
Mailing Address - Street 1:734 E 8TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-1301
Mailing Address - Country:US
Mailing Address - Phone:347-622-2804
Mailing Address - Fax:
Practice Address - Street 1:1068 48TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2934
Practice Address - Country:US
Practice Address - Phone:347-622-2804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty